Accurate puncture and dilation of the target kidney calices for percutaneous nephrolithotomy (PCNL) can be difficult. This study aimed to investigate the advantages of PCNL using optical puncture (i.e. the puncture is visualized on a screen as seen through the needle) combined with balloon dilation vs. conventional puncture methods. This was a retrospective study of 58 consecutive patients with kidney stones without hydronephrosis and treated at the Minimally Invasive Urology Center of Zhejiang Provincial People’s Hospital between 10/2016 and 12/2017. Twenty-one patients underwent optical puncture combined with balloon dilation PCNL. Thirty-seven patients underwent conventional puncture instrument dilation PCNL (controls). Success rate, tubeless rate, blood loss, pain, and complications were compared between the two groups. The one-time puncture success rate (95.2% [20/21] vs. 67.6% [25/37], P = 0.02) and the postoperative tubeless rate (81.0% [17/21] vs. 54.1% [20/37], P = 0.04) were higher in the optical puncture group compared with controls. The average postoperative hemoglobin reduction was smaller (1.13 ± 0.63 vs. 1.56 ± 0.59 g/dL, P = 0.01), the postoperative VAS score was lower (1.6 ± 0.9 vs. 2.5 ± 1.2, P = 0.004), the rate of postoperative analgesic use was lower (14.3% [3/21] vs. 40.5% [15/37], P = 0.04), and the postoperative mean hospitalization days was shorter (3.7 ± 0.9 vs. 4.4 ± 0.8, P = 0.005) in the optical puncture group vs. controls. There was no case of urinary sepsis, blood transfusion, perirenal hematoma, pleural injury, and visceral organ damage. Optical puncture combined with balloon dilation PCNL could be associated with good therapeutic effect and low frequency of complications for the treatment of kidney stones without hydronephrosis.

中文翻译：

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光学穿刺联合球囊扩张PCNL与常规穿刺扩张PCNL对无肾积水的肾结石的回顾性研究

经皮肾镜取石术（PCNL）可能难以准确穿刺和扩张目标肾脏肾结石。这项研究旨在研究与常规穿刺方法相结合的与光学球囊扩张相结合的光学穿刺（即穿刺在屏幕上可视化，通过针头观察）的PCNL的优势。这是一项回顾性研究，对58例无肾积水的肾结石患者进行了回顾性研究，并在10/2016至12/2017之间在浙江省人民医院微创泌尿外科中心进行了治疗。21例患者接受了光学穿刺并结合球囊扩张PCNL。37例患者接受了常规穿刺器械扩张PCNL（对照）。比较两组的成功率，无管率，失血量，疼痛和并发症。一次性穿刺成功率（95.2％[20/21]对67.6％[25/37]，P = 0.02）和术后无管率（81.0％[17/21]对54.1％[20/37] ]，P ＝ 0.04）在光穿刺组中比对照组高。术后平均血红蛋白减少较小（1.13±0.63 vs. 1.56±0.59 g / dL，P = 0.01），术后VAS评分较低（1.6±0.9 vs. 2.5±1.2，P = 0.004），术后发生率镇痛的使用率较低（14.3％[3/21]对40.5％[15/37]，P = 0.04），术后平均住院天数较短（3.7±0.9对4.4±0.8，P = 0.005）。光学穿刺组与对照组的比较。没有尿毒血症，输血，肾周血肿，胸膜损伤和内脏器官损害的病例。